Implanted medical devices, such as pacemakers, typically include wireless telemetry circuitry to permit monitoring and programming of the device by an external monitor or programmer. In addition, some monitors and programmers include a telecommunication interface to communicate remotely with a remote monitoring station. In this manner, some monitors and programmers support remote monitoring and programming of implanted medical devices, e.g., via a dial-up telephone connection or network connection.
Typically, to commence monitoring, a remote monitoring station operator calls a patient and establishes a two-way telephone connection. A person at the remote monitoring station guides the patient to set up the connection, place surface electrodes on the patient's chest for surface ECG recording, and turn on the monitor or programmer to interrogate the pacemaker implanted within the patient. In particular, the patient places a wand that contains a radio frequency (RF) antenna in proximity with the implanted pacemaker.
The monitor or programmer receives data from the implanted pacemaker and stores the data for communication to the remote monitoring station, e.g., via a telephone or network connection. In addition, data collected from the surface ECG recording is transmitted to the remote monitoring station, typically using transtelephonic frequency modulation (FM). Collection and transmission of implanted medical device data and surface ECG data in this manner is useful in providing the remote monitoring station with remote access to critical patient information.
Existing systems place great reliance, however, on the patient to take certain actions in a timely and accurate manner. To ensure accurate data recording, for example, the patient must be trained to quickly and accurately position the wand and ECG monitoring electrodes. If the patient is not sufficiently adept in handling wand or electrode placement, interrogation may take longer than desired, possibly resulting in undue depletion of the pacemaker battery.
Thus, inappropriate actions on the part of the patient can be a significant problem in affecting longevity of a pacemaker. With implantable cardioverter/defibrillators (ICD), it is even more important to interrogate the device as well as assess surface ECG simultaneously. Collecting the surface ECG recording in combination with retrieving the contents of the implanted medical device can yield additional clinical information in the assessment of the operation of the implanted medical device.